Ces radiol. 2011, 65(4):279-288

Effect of the presence of calcium in the coronary arteries to the cardiac functionOriginal article

Aleš Neumann¹, Šárka Bohatá², Miloš Keřkovský³, Tomáš Pavlík⁴

¹ Radiologická klinika FN Brno a LF MU, Brno

² Institut biostatistiky a analýz MU, Brno

Aim: To correlate the presence of calcium in the coronary arteries to the functional and morphological parameters characterizing the cardiac function.

Method: In a group of 45 patients we measured the CT calcium score values (Agatston). From the functional parameters were determined the ejection fraction, ejection volume, cardiac output, cardiac index and left ventricle systolic wall stress (LVSWS). We correlated the observed values of functional parameters according to the presence of calcium in the coronary arteries. Becouse of the group inhomogeneity, the whole group was divided into two sub-groups according to the clinical indication for the MDCT examination: one of them was the group of the patients examined prior to the radiofrequency ablation, indicated for the atrial fibrillation (RFA), the second one was the group in whom the coronary artery disease was suspected (CAD). We compared the values for each group separately and also both groups with each other, to identify differences.

Results: Out of all 45 patients, 17 patients were examined because of the suspected coronary disease (group CAD) and 28 patients prior to the catheter ablation of atrial fibrillation (group RFA). The coronary arteries calcifications were found in 58.8% of the subjects within the group CAD and in 35.7% within the group RFA.
There were no statistically significant differences in the observed parameters between the groups differentiated by the type of clinical indication, the difference was borderline in case of LVSWS.
There were no statistically significant differences between the groups differentiated to the presence of calcium in the coronary arteries in EF, SV and CI, the EV and LVSWS were borderline insignificant. Within the group RFA, the patients with non-zero values of CS had significantly lower values of LVSWS than the patients without coronary calcifications.

Conclusion: We did not demonstrate the effect of the presence of calcium in the coronary arteries to the parameters of central circulation (cardiac output, cardiac index) nor parameters of global function of left ventricle (ejection fraction, ejection volume). We proved the statistically significant decrease of the LVSWS values in patients with coronary calcium within the RFA sub-group. LVSWS is a determinant of oxygen consumption.
We also obserdved the decrease of LVSWS in the CAD group of patients. There were higher values of LVSWS in the CAD group compared to the second group. All these results were not statistically significant.
From the results of the study we could conclude, that the presence of calcifications (respectively value of CS) does not reflect the severity of systolic dysfunction caused by CHD. We can assume the possible influence of calcium in the coronary arteries to the reduction of myocardial oxygen consumption.

Keywords: coronary CT angiography, calcium score, parameters of cardiac function

Accepted: September 15, 2011; Published: December 1, 2011  Show citation